Filling the gap: Understanding complementary feeding practices in early care and education settings

The transition to complementary foods beginning around 6 months of age represents a sensitive period in the development of human eating habits and preferences, and associations with food and eating (Mura-Paroche, Caton, Vereijken, Weenen, & Houston-Price, 2017). This period is a key opportunity to address childhood health and nutrition (UNICEF, 2020) as established dietary behaviors appear to track into adulthood (Saavedra, Deming, Dattilo, & Reidy, 2013). Early care and education (ECE) settings are influential environments for children during this period (Benjamin-Neelon, 2018) as 30% of infants < 1 year of age attend center-based childcare arrangements (U.S. Department of Education, 2021), where they spend, on average, 31 hours per week (U.S. Department of Education, 2019). Yet, there is a critical gap in understanding of teacher feeding practices with infants during the complementary feeding, as no instruments have been developed to capture and assess teacher feeding practices during this key developmental period. Therefore, the first aim of this research included development and validation of a questionnaire to understand how teachers navigate infants’ transition to complementary feeding. Validity was established by expert review (N=3) and cognitive interviews (N=2). N=126 teachers completed the online questionnaire. Test-retest reliability (n=24) was not established for most questionnaire items. Most teachers reported taking the lead on guiding infants’ transition to CF often (43.7%) or always (31.7%). Teachers differed in agreement on the use of developmental readiness cues to introduce complementary food based on the ECE policy context they worked in (χ2(2) = 6.820, p = .033). The second aim was to develop an observational measure to define and capture responsive feeding practices of infant teachers during the transition to complementary foods. Responsive feeding refers broadly to the support of children’s hunger and satiety cues (Satter, 2016). A coding scheme was developed using an iterative observational design. N=18 pilot mealtime observations were coded. Novel operational definitions of 5 responsive feeding practices were refined through the iterative coding process. There were many aspects of teachers’ responsive feeding practices that appear specific to the ECE context or transition to complementary feeding period. Teachers used more responsive practices (79.7%) than non-responsive practices (20.3%) during mealtimes with infants. Overall, this research offers unique insight into complementary feeding practices and represents an important first step in better understanding feeding practices within ECE settings during a critical period in the development of eating behaviors.

Name thesis:degree_name

Ph.D.

Level thesis:degree_level

Dissertation

Discipline thesis:degree_discipline

Nutritional Sciences

Grantor

University of Illinois at Urbana-Champaign

Year dc:date

2022

Author dc:creator

• Lundquist, Alexandra

Contributors dc:contributor

• Donovan, Sharon M
• McBride, Brent A
• Chapman-Novakofski, Karen
• Fiese, Barbara H

• Nutrition
• Infant feeding
• Complementary feeding
• Transition to solids
• Childcare
• Early care and education
• Responsive feeding
• Feeding practices

Statement dc:rights

• Copyright 2022 Alexandra Lundquist

Language dc:language

en, eng

Handle dc:identifier

https://hdl.handle.net/2142/115714

OAI record oai:identifier

https://www.ideals.illinois.edu/oai-pmh?verb=GetRecord&metadataPrefix=etdms&identifier=oai%3Awww.ideals.illinois.edu%3A2142%2F115714